The nurse is inspecting the genitals of a prepubescent girl. Which is a normal sign of the onset of puberty?

A. Body weight: Body weight is the most reliable indicator of fluid loss, as changes in weight directly reflect changes in fluid balance. Monitoring weight is essential for assessing dehydration and guiding fluid replacement therapy.

B. Skin integrity: While changes in skin turgor and skin integrity can be indicators of

dehydration, they are less reliable in infants, especially if they have certain skin conditions or are very young.

C. Respiratory ratE. Although increased respiratory rate can occur as a compensatory mechanism for metabolic acidosis associated with dehydration, it is not as reliable as changes in body weight for assessing fluid loss.

D. Blood pressurE. While blood pressure may be affected by severe dehydration, it is not as sensitive or practical as monitoring body weight for assessing fluid loss in infants.

A. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016: While diabetes insipidus requires monitoring and management, a urine specific gravity of 1.016 alone does not indicate acute distress or an emergency situation. The child may need adjustments in fluid intake or medication, but this can typically be addressed in a less urgent manner.

B. A 10-year-old child who has sickle cell anemia who reports severe chest pain: Severe chest pain in a child with sickle cell anemia could indicate a vaso-occlusive crisis affecting the chest, which is potentially life-threatening. Prompt assessment and intervention are necessary to

manage the pain and prevent complications, including acute chest syndrome or respiratory compromise.

C. A 1-year-old toddler who has roseola and a temperature of 39°C (102.2°F): Roseola is typically a benign viral illness characterized by fever and a rash. While a fever in a young child

requires monitoring and symptomatic management, it is not usually considered an emergency unless accompanied by other concerning symptoms such as dehydration or respiratory distress.

D. A 4-year-old child who has asthma and a PCO2 of 37 mm: While asthma exacerbations can be serious, a PCO2 level of 37 mm indicates normal carbon dioxide levels, which do not suggest acute respiratory distress or impending respiratory failure. However, if the child is experiencing severe respiratory distress, cyanosis, or altered mental status, immediate assessment and

intervention would be warranted.